ASTHMA AND CHILDCARE PART 1 Presented by: Robin Costley, CRT, AE-C Marion County Public Health Department Manager, Asthma Alliance of Indianapolis
OBJECTIVES By the end of training, participants will: Understand the basics of asthma Identify common asthma triggers Recognize symptoms of an acute asthma attack Identify types of asthma treatment Understand the responsibilities of childcare providers
ASTHMA IN INDIANA 9.5% of Indiana children have asthma Approximately 150,000 children Children age 0-4 have the highest rates of emergency department visits for asthma of any age group in Indiana Asthma is the leading cause of absenteeism in Indiana
ASTHMA CONTROL AMONG CHILDREN (0 17 YEARS), INDIANA, 2006 2010 Well controlled 27.0 Not well controlled 54.7 Very poorly controlled 18.3 0 10 20 30 40 50 60 70 Percent *Percents are presented with 95% confidence intervals. Source: CDC and ISDH DAT. (2012). Behavioral Risk Factor Surveillance System Child Multi-year Asthma Call-back Survey, 2006-2010.
ASTHMA DEFINITION Asthma is a chronic inflammation of the bronchial tubes (airways) that causes swelling and narrowing (constriction) of the airways. The result is difficulty breathing. Narrowing is usually totally or partially reversible when treatments are initiated quickly. Untreated asthma may cause scar tissue in the lungs.
Early Asthma Tightening of the muscles narrows the air tube and impedes flow Late Asthma Lining of the airway becomes inflamed with swelling and mucus production
ASTHMA SYMPTOMS Cough and/or wheeze Difficulty breathing with or without exercise Chest tightness Breathlessness Presence of other allergic conditions Eczema Rhinitis (runny nose) or sinusitis Very loud wheezing Altered/slowed growth patterns
MOLD PET DANDER HOUSE DUST/ CLEANING SECONDHAND SMOKE EXERCISE TEMPERATURE CHANGES/ POLLEN HOUSEHOLD PESTS VEHICLE EXHAUST CHEMICAL FRAGRANCES PESTICIDES
ASTHMA TRIGGERS: ALLERGENS Trigger Dust mites Found in carpet, bedding, stuffed animals Can cause asthma, as well as trigger symptoms Pet Dander To Reduce Exposure: Dust mites Vacuum regularly (HEPA preferred) Wash bedding and stuffed animals weekly in hot water Remove carpeting if possible Do not allow pets with fur or feathers inside (dander may still be on people s clothing)
ASTHMA TRIGGERS: ALLERGENS Trigger Pests To Reduce Exposure: Immediately clean crumbs and spilled liquids. Store foods in sealed plastic containers. Remove all cardboard containers. Place garbage in trash cans with fitted lids. Empty trash cans daily. Watch for puddles from leaking pipes, etc. Seal cracks around doors, windows, and foundation.
ASTHMA TRIGGERS: ALLERGENS Trigger Mold To Reduce Exposure: Have proper ventilation and air circulation Repair water leaks immediately Clean moldy surfaces with bleach water Empty dehumidifier pans and refrigerator condensation pans Avoid overwatering plants Replace absorbent materials that have been wet for more than 48 hours Keep indoor humidity <50%
ASTHMA TRIGGERS: IRRITANTS Trigger Odors To Reduce Exposure: Avoid products with strong odors: perfume, scented candles, cleaning products with strong odors, etc. Tobacco Smoke Encourage parents who smoke to do so outside the home and car. Wear a jacket when smoking outside that can be removed before returning to the classroom (the chemicals stay on hair and clothes).
ASTHMA TRIGGERS: IRRITANTS Trigger Air Pollution To Reduce Exposure: Limit outdoor activities when pollution levels are high (www.smogwatch.in.gov). Request that parents avoid idling their vehicles. Changes in Weather Try to breathe through the nose. Cover mouth with a scarf or mask when outdoors in the cold. Check pollen count and mold counts and limit outdoor activities during high levels (www.aaaai.org/nab)
EXERCISE INDUCED ASTHMA Additional symptoms include: Endurance problems during or after vigorous activity Exercise induced asthma episodes begin during exercise Peak 5-10 minutes into exercise Symptoms often spontaneously resolve in another 20-30 minutes
ASTHMA MANAGEMENT GUIDELINES Identify allergenic and environmental triggers Avoid triggers as much as possible Avoid exposure to tobacco smoke Have a yearly influenza vaccine Receive all recommended childhood vaccines Early anti-inflammatory treatment is important All children with asthma need a short-acting inhaled medication as needed for symptom control Many will require daily long-term control medications
ASTHMA MANAGEMENT GOALS Minimal or no chronic symptoms, day or night Minimal or no episodes No limitations on activities No missed school days or parent sick days Minimal use of rescue medications Maintain (near) normal pulmonary function Minimal or no adverse side effects from medications
ASTHMA MANAGEMENT PLAN Every child with asthma should have one Completed by a health care provider Should include list of known asthma triggers Should include list of medications, what they are used for, and when to use them Includes zones based on current symptoms and actions to take during each zone